dc.contributor.author | Olsen, Erik | |
dc.contributor.author | Holzhauer, Björn | |
dc.contributor.author | Julius, Stevo | |
dc.contributor.author | Kjeldsen, Sverre | |
dc.contributor.author | Larstorp, Anne Cecilie Kjeldsen | |
dc.contributor.author | Mancia, Giuseppe | |
dc.contributor.author | Mehlum, Maria Hollund | |
dc.contributor.author | Mo, Rune | |
dc.contributor.author | Rostrup, Morten | |
dc.contributor.author | Søraas, Camilla Lund | |
dc.contributor.author | Zappe, Dion H. | |
dc.contributor.author | Weber, Michael A. | |
dc.date.accessioned | 2021-10-13T05:58:59Z | |
dc.date.available | 2021-10-13T05:58:59Z | |
dc.date.created | 2021-01-15T16:50:56Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | Blood Pressure. 2021, . | en_US |
dc.identifier.issn | 0803-7051 | |
dc.identifier.uri | https://hdl.handle.net/11250/2789466 | |
dc.description.abstract | Purpose
Event-based clinical outcome trials have shown limited evidence to support guidelines recommendations to lower blood pressure (BP) to <130/80 mmHg in middle-aged and elderly hypertensive patients with diabetes mellitus or with general high cardiovascular (CV) risk. We addressed this issue by post-hoc analysing the risk of CV events in patients who participated in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial and compared the hypertensive patients with type 2 diabetes mellitus with all high-risk hypertensive patients.
Materials and methods
Patients were divided into 4 groups according to the proportion of on-treatment visits before the occurrence of an event (<25% to ≥75%) in which BP was reduced to <140/90 or <130/80 mmHg. Patients with diabetes mellitus (n = 5250) were compared with the entire VALUE population with high CV risk (n = 15,245).
Results
After adjustments for baseline differences between groups, a reduction in the proportion of visits in which BP was reduced to <140/90 mmHg, but not to <130/80 mmHg, was accompanied by a progressive increase in the risk of CV morbidity and mortality as well as stroke, myocardial infarction and heart failure in both diabetes mellitus and in all high-risk patients. Target BP <130/80 mmHg reduced stroke risk in the main population but not in the diabetes mellitus patients. Patients with diabetes mellitus had higher event rates for the primary cardiac endpoint and all-cause mortality driven by a higher rate of heart failure.
Conclusion
In the high-risk hypertensive patients of the VALUE trial achieving more frequently BP <140/90 mmHg, but not <130/80 mmHg, showed principally the same protective effect on overall and cause-specific cardiovascular outcomes in patients with diabetes mellitus and in the general high-risk hypertensive population. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Taylor & Francis | en_US |
dc.title | Cardiovascular outcomes at recommended blood pressure targets in middle-aged and elderly patients with type 2 diabetes mellitus compared to all middle-aged and elderly hypertensive study patients with high cardiovascular risk | en_US |
dc.type | Peer reviewed | en_US |
dc.type | Journal article | en_US |
dc.description.version | acceptedVersion | en_US |
dc.rights.holder | This is the authors' accepted manuscript to an article published by Taylor & Francis. Locked until 6.1.2022 due to copyright restrictions. | en_US |
dc.source.pagenumber | 0 | en_US |
dc.source.journal | Blood Pressure | en_US |
dc.identifier.doi | 10.1080/08037051.2020.1856642 | |
dc.identifier.cristin | 1872372 | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.fulltext | postprint | |
cristin.qualitycode | 1 | |